22224 HIGHWAY 99.PDF11111111111111
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22224 HIGHWAY 99
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
TO:
LU
0
Uj
SUSPENSE DATE:
DIRECTOR
Investigate
and Report
Take Appropriate
Action
Prepare
letter/memo
for my signature
For Information
Previously Ref'd
Status of Action?
Return to:
ADMINISTRATIVE SECRETARY
ASST. CITY ENGINEER
BUILDING & GROUNDS SUPT.
EQUIPMENT RENTAL SUPT.
STREET DIVISION SUPT.
TREATMENT PLANT SUPT.
WATER/SEWER SUPT.
.4� �,
COMMENTS:
—ya—
FROM:
DATE:
.11 d,
(3177)
4 f-I -"Nl
CITY OF ]EbMO
NDS----, SM SM, k
*AT=4MWM
*7��
PERIVUT
CaU 775-S&M for Ad* sewer inspections BZF"X � coveftS &Ay portion of the tougmation. i
ftspection will be provided within 24 hours Wner "WAA. No SaL, gan., or jsoikigy "Woontions.j
!ADDUM LOCAMON OF CONNT
'P%0*=rY UWAL DMCRMMO
. .......... . .................. . ...... . .......... . ..
77W
7 2
... . .. . .. . . . ..... . .... . ................................. . .......... ..... . .............. .
COMPMAOMS-19 NAA& "DWM ....... . .... ................ ..................... ....................... . ...... . .. . .. . ................ . ....... . ... .........
Pal ah" Is 1-9-V7, tor ftpo& Swor GOVAMUM ot a a& Mwer to aie CKY AMM"My Be,~,
=*9d W--IRQYV=0-tI= 0- AM ... ... M-I&
A IN 11�111:
a Permit to construct newer IvAide A licensed side Stwor Contractor must be empl"St to construct'
any portion of sowar before it has bW""%Z=
M 2-� work perfortned in c4ty right-,ot-way rwmares an Invasion of Pight-ot-Way pWWt WUU*# front the city xngtneces office.
OM W *—ObtWa full. Infortuation regarding Ordinance 11.164N and Re"wtions govaoftg aide nwen when you, tot pervatt.
NOTM M 4—=Ado sower xnust have at least 30 Inches coveme at property Jim &Ad Is in WSWO pro IMS: 2
ab" perty Manbum gmd* of No bona in grab
then % will be perraitted.
NOTM No. 5—Tremebes in ==Ipbe
.=r settled #Ad surface of greet restored to original condition. Coatrastm sh&H be rosposudigo tw "am" #0 to
work Which on* year at coutpletion. finproor
270= No. 4--it to Unlawful to alter or do any other work than, is provided for In the MmX or to 4a say work an the main "War or 4, s"Urtsag""
I sort the Poe into the Wye, except to In-
IIXIEI�� 0 IftIL& .. . .......................... ........ By ............... . ]W&.. ........ ...... . .. . .. — - ---- - --------- By ..............
APPXOVXD ot5sta.
is, =2-AT .............. IST --- ............................. ............... ........................................
.. . .. ... . ....... .................. . ......................
I .. . ...... .. . ... . ...... ..... ........................................................... . . . . ..................... .... ...... ..............................
low Permit ChWes XUST,13e By Owner of NUM Perrorming Constmetift Staquent F.W uvlld�,
4 .......... . ...................... . ........................... . ...... . ........... ... hereby oertity ft" Me www im""on ftextruoted under tift
(Owner of Contracting Arm IRWonaing Construction) permit
ifWtg� In amlrdance with all governing ordlml=esof the City at NdmenU
Dated .........
C)
p-:
%ir
11::PT. WD71, LIS
1,3PILDENG, P1T';IT
Strcot rdflit-oF-Way Existinr JDC5 �O(C> IUDD
Access Fasciments Existing Unl)
mcUtility Fascinont Existinry PTOD
Lot Por Sui)divisjon Plat Assessor ITap
-m (1od.od for I Accurac.,,- KC) PLAN <Zw(-N"
Site Pl, —..a" --qTv_O
"'Cod.
O'C�C�, pculfow �,.l L-Po(d
"ain
r'-d
lk-dran't ("i -
t
H%'(1,T-an't Pcrl I-C, d f"'Or F1
ZC
Pctector
e
I t C,
sc-ptic 1"mi:
S,-i-.tl. . -,ml, Pen"JA T,.c(!.L1i.1-Cd F m i t '7o.
Sunit'll-v lev:c- -hilin. 11roi.
RIC '70.
Side *t,
Smitmy .1A.n-er Connection Fee Poquircd
P"View -!)a t 0.
!1(ni Dit - A
011 vort 1, —d Si.zc
re 0
Catch MIS 11 Rc(iui C."Ite oil �i te !"Inn
cr,
N'111,10le required-- Indiultv 0 PIM"
ditions F, Grouild 1"'ater Field (10c,"Od
1000 Date
AdIk
Str t. I'a-ving, Rcquircd
ftirb in(! tcr Rcomi.rod
SidcwaR Peouirc
Dirl) Put for Driveway Rc. 'rcd
Pi ConstructIon PCIIIIi drod
Bond Rcquired for Ni Improvaments
Strcct N,ai-,i, !\Icquircd
0 r Signiri, 1"coui rccl
Pr Site Inspcction nacic on
c
Y:
u Water
stycct--
1711ginecrinp
sped'al Pcquirmcmts listcd in ii(-,-,?,o to Buildin(,,
),Ito
I ]),,14 1 (1 i ng,
itc;lls fi-1).ccl ill ol A. A. Pcnmit Application
1)"Itc
C; .0
Pravdn"Tsl Stariped and" taticlis �.,.,alc
By BN )--- ---- Date
Approircd II)y PLI'Dl iC
CITY OF EDMONDS
PUBLIC ORKS DEPARTMENT, ENGINECRIO DIVISION
APPLICATION FOR RIGHT-OF-WAY CONSTRUCTION PERNT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
A Permit to be issued to
For Work at:(address or vicinity)
Type of Wo.rk to be done:
(attach drawing when applicable)
Time Required -- Start: Finish:
Owner: Z�2�0/
Name
-A "ZI 't��z ix
Mailing Address
0 Zell
'city State Zip Tel�phone Number
Contractor:4'1- 2
0��4 -,3--6/ - /I
-0/— �&ko
Name State License Number
Mailing Addres's'
c-,
�City State Zip Telephone Number
B. INDEMNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workma nship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit'(estimated restoration fee) will be held until
the final street patch is completed, at which -time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must be available at the job site for inspection
purposes at all times.
Date
Signature:
Owner or Agent
TO BE COMPLETED BY ISSUING AGENCY: '2_2
Fee:
Date Issued:,,� 2 -Permit No.:'Ze'
Security Bond:/
Time Authorized:—
k_� �� �_ D a t e
APPROVED BY-
0 1- - "'
5 e? LsD
-7-0-1- 7-;�,
July 31, 1978
MEMO TO: Art Housl'er, Director
Finance Department
FROM: Leif R. Larson
Director of Public Works
SUBJECT: REIMBURSEMENT OF STREET CUT SECURITY.DEPOSIT A4 46*
ORDINANCE #1935
R/W CONSTR. PERMIT NO.: 78-114
DATE ISSUED: 5/8//8
LOCATION OF WORK: 22224 Hwy 99 & 222nd 76th Ave.
SECURITY DEPOSIT AMOUNT:. $186.00 '
RECEIPT NO. & DATE: #4283 5/8/78
COMPLETION DT. OF REPAIR: 6/19/78
Please prepare a Treasurer's Check in the amount of $22.58
made payable to the following:
Ben Holt
22224 Highway 99
Edmonds., WA 98020
The balance of the deposit in the amount of $ 163.42 is
to remain in Street Division Revenue Fund 111-000-0007389.10.
.............
'J .. E ."S Date C.E..& Acting Dir.
of P.W. Date
7131/78
MEMO TO: Art Housler, Director
Finance Department
FROM: Leif R. Larson
Director of Public Works
SUBJECT: REIMBURSEMENT OF STREET CUT SECURITY DEPOSIT
ORDINANCE #1935
R/W CONSTR. PERMIT NO.:
DATE ISSUED:
LOCATION OF WO1.ZK:�LX;ZMZA A4(
SECURITY DEPOSIT AMO
RECEIPT NO. & DATE:
COMPLETION DT. OF REPAIR:
Please prepare a Treasurer's Check in the amount of $
made payable to the following:
404V
fir
The balance of the deposit in the amount of $ ZC to
Z I s
remain in Street Division Revenue Fund 111-000-000-38 .10.
1V
PUB* -ORKS' DEPARTMENT, ENGINAI-1 DIVISION
N FOR RIGHT-OF-UAY CONSTRUCTION PERNT
APPLICAT10f
THIS PERMIT MUST BE AVAILABLE AT 111E. JOB SITE FOR INSPECTION PURPOSES
Applicant to Comple,te Parts A and-B
A. Permit to be is�sued t 0
cp
For Work at:(address or vicinity)
Type,of Work to be done:
(attach drawing when applicable)
Time Required -- Start: Finish: Xe _�)_A I
Owner:
N7ame
Mailing Address
4"
'City State Zip Telephone Number
Contractor: /_14/9- r;;7-
Name
Mailing AddrEZs'
2
.-City State Zip
State License Number
Telaphone Number
INDEMNITY: Applicant unders tands and by his sign ature I to -thi s . application," a 9 r 6 . e s
.to�hold-the City of Edmonds harmless from any injuries, dam "''-or claims of any
ages,
kin'd or.,description whatsoever, foreseen or unforeseen, that may be made;'a gainst
the applicant 'or the City -of Edmonds, or any,ofits departmen.ts' or e'
mploy-ees.,
ioncluding-or not limited to theldefense of any legal proceiedings, in ludin:g:-,.-,d6 'fe'nse,
q
costs, court costs,. and at-torney fees by reason of 'rmit.'
granting this pe
Upon.,iss.uance o,f this permit., the contractor is4responsible for km'anship-, and
'w
mat,erlals.' for. a period, of one: year f ollowing 'the, final `insipet'ti,�n and accep tanke.
of the,� r(`�s torati-6n by,, the Engineering Div
ision.
Funds held from'th6..Securlity Deposit (estimated restora�i w
6 le64 ill be held�unt
the f irial street Pa:tch� is completed, at which -t im6o a debit or-"cr.edit wi e
processed: for issuance to the applic"ant.
Work.is sijbjE�Lt, to*�ins'pection. and restoration in accordance 4it K.-,* CT''
w fty C_6de,A.%:
24-hour n.otice-'i-s:r-equiired for inspection by En -252-5, ..6x,t '!'2;20.,,�-_,
..g.ineeri,ngi Call; 775
I'understan
d,,,,that, this. -permit must be 'available at. the jnspectio�j-
job site��, or
:a 11-: t 1M6 s
pqrPoses at
4,Signature: 7 Dat
e
Owneror Agent
CbMPLE:TED, BY :1-S:SU-ING AGENCY: L I Z_
,'Dd"t:'e* I,s-s u -e,d
Permit No.
t
ecuri
S
ILL
Time A,,4, thp:t I z,e'd-.:'!
APPROVE'D B
CITY OF EDMONDS
PUB0 WORKS DEPARTMENTj ENGINOING DIVISION
APPLICATION FOR RIGHT-OF-WAY CONSTRUCTION PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A an'd B
A, Permit to be issued t o
For Work at :(address or vicinity)
Type of Work to be done:
X,.
(attach drawing when a'plicable)�
p
Time Required -- Start:
Finish:
Owner:.,.��e_,? -7
Name
Mailing Address
7 �;;,7c
City State Zip
Telephone Number-#
Contractor!,
;1 3 1� 0
Name State License Number
Maill7n Address
City State Zip Telephone Nuffil3er
B. INDEMNITY: Applicant understands and by his signature to this application, agrees
to.hold the City of Edmonds.harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen 'or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited to the defense of any legal proceedings -including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the. restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must.be available at the job site for inspection
purposes at all times.
Signature. Date: 1,2-13-
er or gent
TO BE COMPLETED BY ISSUING AGENCY:
Permit No.: Fee:)/s
Date Issued
Security Bond:
Time Authorized: -10
APPROVED BY
1()-//Iv (Kevised)
-Date �17